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Airway management and endoscopic treatment of subglottic and tracheal stenosis: the laryngeal mask airway technique.
Ann Otol Rhinol Laryngol. 2014 Apr; 123(4):293-8.AO

Abstract

OBJECTIVES

The objective is to present clinical outcomes of subglottic and tracheal stenosis treated by flexible bronchoscopic delivery of carbon dioxide (CO2) laser via laryngeal mask airway (LMA).

METHODS

All consecutive, nontracheotomy dependent cases of subglottic and tracheal stenosis treated endoscopically over a 4-year period were retrospectively reviewed. The surgical approach consisted of radial incisions using a flexible fiber-based CO2 laser, balloon dilation, and topical application of mitomycin C. Ventilation during the procedure occurred through the LMA, and the CO2 laser fiber was delivered through the working channel of a flexible bronchoscope passed through the LMA. Number of dilations, period between dilations, and operative times were reviewed.

RESULTS

Eleven patients who underwent airway intervention during the study period were identified. Average follow-up was 28 months. Etiologies of airway stenosis included intubation injury (6), idiopathic (4), or autoimmune disease (1), requiring an average of 1.3, 1.5, and 3 dilations, respectively. Average operative time was 67 minutes. Autoimmune etiology correlated with more frequent dilations.

CONCLUSION

LMA is an effective way to manage ventilation while simultaneously allowing unencumbered flexible bronchoscopic access for laser surgery, balloon dilation, and mitomycin C application for airway stenosis. Long-term success in treating stenosis is achievable using this technique.

Authors+Show Affiliations

Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24671485

Citation

Vorasubin, Nopawan, et al. "Airway Management and Endoscopic Treatment of Subglottic and Tracheal Stenosis: the Laryngeal Mask Airway Technique." The Annals of Otology, Rhinology, and Laryngology, vol. 123, no. 4, 2014, pp. 293-8.
Vorasubin N, Vira D, Jamal N, et al. Airway management and endoscopic treatment of subglottic and tracheal stenosis: the laryngeal mask airway technique. Ann Otol Rhinol Laryngol. 2014;123(4):293-8.
Vorasubin, N., Vira, D., Jamal, N., & Chhetri, D. K. (2014). Airway management and endoscopic treatment of subglottic and tracheal stenosis: the laryngeal mask airway technique. The Annals of Otology, Rhinology, and Laryngology, 123(4), 293-8. https://doi.org/10.1177/0003489414525340
Vorasubin N, et al. Airway Management and Endoscopic Treatment of Subglottic and Tracheal Stenosis: the Laryngeal Mask Airway Technique. Ann Otol Rhinol Laryngol. 2014;123(4):293-8. PubMed PMID: 24671485.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Airway management and endoscopic treatment of subglottic and tracheal stenosis: the laryngeal mask airway technique. AU - Vorasubin,Nopawan, AU - Vira,Darshni, AU - Jamal,Nausheen, AU - Chhetri,Dinesh K, PY - 2014/3/28/entrez PY - 2014/3/29/pubmed PY - 2014/10/17/medline KW - CO2 laser KW - airway management KW - balloon dilation KW - laryngeal mask airway KW - subglottic stenosis KW - tracheal stenosis SP - 293 EP - 8 JF - The Annals of otology, rhinology, and laryngology JO - Ann. Otol. Rhinol. Laryngol. VL - 123 IS - 4 N2 - OBJECTIVES: The objective is to present clinical outcomes of subglottic and tracheal stenosis treated by flexible bronchoscopic delivery of carbon dioxide (CO2) laser via laryngeal mask airway (LMA). METHODS: All consecutive, nontracheotomy dependent cases of subglottic and tracheal stenosis treated endoscopically over a 4-year period were retrospectively reviewed. The surgical approach consisted of radial incisions using a flexible fiber-based CO2 laser, balloon dilation, and topical application of mitomycin C. Ventilation during the procedure occurred through the LMA, and the CO2 laser fiber was delivered through the working channel of a flexible bronchoscope passed through the LMA. Number of dilations, period between dilations, and operative times were reviewed. RESULTS: Eleven patients who underwent airway intervention during the study period were identified. Average follow-up was 28 months. Etiologies of airway stenosis included intubation injury (6), idiopathic (4), or autoimmune disease (1), requiring an average of 1.3, 1.5, and 3 dilations, respectively. Average operative time was 67 minutes. Autoimmune etiology correlated with more frequent dilations. CONCLUSION: LMA is an effective way to manage ventilation while simultaneously allowing unencumbered flexible bronchoscopic access for laser surgery, balloon dilation, and mitomycin C application for airway stenosis. Long-term success in treating stenosis is achievable using this technique. SN - 0003-4894 UR - https://www.unboundmedicine.com/medline/citation/24671485/Airway_management_and_endoscopic_treatment_of_subglottic_and_tracheal_stenosis:_the_laryngeal_mask_airway_technique_ L2 - http://journals.sagepub.com/doi/full/10.1177/0003489414525340?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -